Dynamic perfusion MRI: Capability for evaluation of disease severity and progression of pulmonary arterial hypertension in patients with connective tissue disease

Abstract

Purpose:To prospectively evaluate the capability of dynamic perfusion MRI for assessment of disease severity and progression to pulmonary arterial hypertension (PAH) in connective tissue disease (CTD) patients. Materials and Methods:In all, 18 gender-and agematched CTD patients without and with PAH and nine healthy volunteers underwent dynamic perfusion MRI, Doppler echocardiography, and pulmonary function test. Disease severity of CTD was assessed in terms of diffusing capacity for carbon monoxide (%DL CO ) and estimated systolic pulmonary arterial pressure (sPAP), and progression of PAH in terms of pulmonary arterial pressure (mPAP) and pulmonary vascular resistance (PVR). From calculated pulmonary perfusion parameter maps, means of pulmonary blood flow (mPBF), pulmonary blood volume (mPBV), and mean transit time (mMTT) were determined as averages of all region of interest (ROI) measurements. To determine disease severity in CTD, all parameters were statistically correlated with sPAP and %DL CO . To determine progression to PAH, all parameters were statistically correlated with mPAP and PVR.Results: All pulmonary perfusion parameters correlated significantly with sPAP and %DL CO (P Ͻ 0.05). mPBF and mPBV correlated significantly with mPAP and moderately with PVR (P Ͻ 0.05). Conclusion:Dynamic perfusion MRI can be used for assessment of disease severity and progression of PAH in CTD patients.

Dynamic MR perfusion imaging: Capability for quantitative assessment of disease extent and prediction of outcome for patients with acute pulmonary thromboembolism

“…During scanning, 100 mL of a contrast material (Omnipaque 300; Daiichi-Sankyo Co., Ltd., Tokyo, Japan or Iopamiron 300; Bayer Pharma, Osaka, Japan) was administered intravenously by means of an antecubital vein at 3-4 mL/s with a power injector (Auto Enhance; Nemoto Kyorindo Co. Ltd., Tokyo, Japan) with an empiric scan delay of 20 s. With this protocol, high and uniform contrast enhancement was consistently achieved for the entire thorax of all patients. (26,28,30), subjects with body weight less than 70 kg were given 5 mL of gadodiamide hydrate (Gd-DTPA BMA, Omniscan; Daiichi-Sankyo) at a dose of 0.3 mmol/mL by means of a cubital vein by means of an automatic infusion system (Sonic shot; Nemoto) at a rate of 5 mL/s, followed by 20 mL of saline solution at the same rate. On the other hand, subjects with a body weight equal to or more than 70 kg, received 5 mL of the same contrast medium at a dose of 0.5 mmol/mL in the same manner and at the same rate, also followed by 20 mL of saline solution.…”

“…On the other hand, subjects with a body weight equal to or more than 70 kg, received 5 mL of the same contrast medium at a dose of 0.5 mmol/mL in the same manner and at the same rate, also followed by 20 mL of saline solution. The basic theory and application of contrast-enhanced dynamic MR perfusion imaging has been documented in previous reports (22,(26)(27)(28). For each scan, 20 images were obtained at end-inspiration of a single breath hold.…”

“…The details of data analysis and reproducibility of dynamic contrast-enhanced MR perfusion imaging have been described in previous reports (22,26,28,30).…”

“…In addition, quantitative assessment of contrastenhanced perfusion MRI can help assess pulmonary physiology, pathophysiology, or disease severity of various pulmonary vascular diseases (22,(26)(27)(28). With this technique, quantitatively assessed regional information of pulmonary circulation in PTE patients can be obtained in routine clinical practice.…”

Contrast‐enhanced multidetector‐row computed tomography vs. Time‐resolved magnetic resonance angiography vs. contrast‐enhanced perfusion MRI: Assessment of treatment response by patients with inoperable chronic thromboembolic pulmonary hypertension

“…With these techniques pulmonary circulation can be assessed both quantitatively and qualitatively, and they have shown moderate to good correlation with quantitative pulmonary circulation parameters assessed with cardiac US and/or right heart catheterization (4)(5)(6)(7)(18)(19)(20)(21). However, there have been no reports on the potential of quantitative and qualitative pulmonary perfusion parameters obtained from dynamic CE-perfusion MRI and time-resolved MRA images for assessment of therapeutic effects on CTEPH patients.…”